FR901228 in Treating Patients With Relapsed or Refractory Non-Hodgkin's Lymphoma

A Phase II Study of Depsipeptide, a Histone Deacetylase Inhibitor, in Relapsed or Refractory Mantle Cell or Diffuse Large Cell Non-Hodgkin's Lymphoma

FR901228 may stop the growth of cancer cells by blocking some of the enzymes needed for cell to grow and by blocking blood flow to the cancer. This phase II trial is studying how well FR901228 works in treating patients with relapsed or refractory non-Hodgkin's lymphoma.

Study Overview

• Status: Terminated
• Conditions: Recurrent Adult Diffuse Large Cell Lymphoma; Recurrent Mantle Cell Lymphoma
• Intervention / Treatment: Drug: romidepsin

Detailed Description

OBJECTIVES:

I. Determine the response rate (complete and partial) to FR901228 in patients with relapsed or refractory mantle cell or diffuse large cell non-Hodgkin's lymphoma.

II. Evaluate the safety and feasibility of FR901228, in terms of the incidence of toxicity and maximum grade observed and courses delayed or dose reductions, in these patients.

III. Determine 2-year progression-free and overall survival.

OUTLINE: Patients receive FR901228 IV over 4 hours on days 1, 8, and 15.

Treatment repeats every 28 days for at least 6 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed every 3-6 months for up to 5 years.

• Study Type: Interventional
• Enrollment (Actual): 9
• Phase: Phase 2

Contacts and Locations

Study Locations

• United States
  • Texas
    • Houston, Texas, United States, 77030
      • M D Anderson Cancer Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Histologically confirmed aggressive B-cell non-Hodgkin's lymphoma of 1 of the following subtypes:

  • Mantle cell lymphoma
  • Diffuse large cell lymphoma
  • (Ineligible for or unwilling to undergo stem cell transplantation)

• Relapsed or refractory disease:

  • Any number of prior therapies allowed for relapsed disease, including peripheral blood stem cell or bone marrow transplantation
  • No more than 2 prior regimens, excluding monotherapy with monoclonal antibody or radiotherapy, for refractory disease
• Measurable disease, defined as >= 1 lesion >= 1.5 cm in the longest diameter
• No transformed lymphoma, defined as the transformation of a low-grade lymphoma, including follicular lymphoma or small lymphocytic lymphoma, to a high-grade lymphoma (e.g., diffuse large cell lymphoma)
• ECOG performance status 0-2
• Absolute neutrophil count >= 1,000/mm^3 OR >= 500/mm^3 if extensive bone marrow involvement (> 50%) or hypersplenism with palpable splenomegaly
• Platelet count >= 75,000/mm^3 OR >= 50,000/mm^3 if extensive bone marrow involvement (> 50%) or hypersplenism with palpable splenomegaly
• Bilirubin normal
• Alkaline phosphatase =< 2 times upper limit of normal (ULN)
• AST =< 2 times ULN
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No significant cardiac disease, including New York Heart Association class III-IV congestive heart failure
• No history of serious ventricular arrhythmia
• QTc < 500 msec
• No evidence of cardiac hypertrophy on ECG
• No known HIV positivity
• No other uncontrolled serious medical condition or active infection (e.g., chronic obstructive pulmonary disease, diabetes)
• Recovered from prior therapy
• No prior doxorubicin hydrochloride >= 450 mg/m^2 or mitoxantrone >= 112 mg/m^2 (Patients who received both mitoxantrone and doxorubicin hydrochloride should have a "doxorubicin equivalent dose" < 450 mg/m^2
• No prior therapy with a histone deacetylase inhibitor
• No concurrent dexamethasone or prednisone except for refractory nausea/vomiting
• No concurrent drugs associated with QTc prolongation (e.g., dolasetron mesylate)
• Concurrent hydrochlorothiazide, furosemide, or other diuretics allowed provided patient is receiving potassium chloride supplementation (No supplementation needed if switched to a potassium-conserving diuretic)
• No CNS lymphoma
• Creatinine normal
• Cardiac function >= 50% by MUGA

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Arm I; Patients receive FR901228 IV over 4 hours on days 1, 8, and 15.	Drug: romidepsin; Given IV; Other Names: FK228; FR901228; Istodax

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Overall Objective Response Rate (Complete Response [CR] and Partial Response [PR]) After 6 Courses of Treatment	International Working Group response for non- Hodgkin's lymphoma: Complete Response (CR) - disappearance all detectable clinical/radiographic evidence of disease and disappearance of all disease-related symptoms (present before therapy) and normalization of those biochemical abnormalities; Partial Response (PR) - ≥50% decrease in sum products of greatest diameters (SPD) of 6 largest dominant nodes or nodal masses, selected by clearly measurable in at least two perpendicular dimensions, from disparate regions of body and no decrease in size of other nodes, liver, or spleen.	24 weeks (6 courses of 4 week cycles)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Median Progression Free-survival (PFS)	Time to disease progression is defined as the time from registration to documentation of disease progression.	2 Years
Median Overall Survival	Survival time is defined as the time from registration to death due to any cause, measured in months. The distribution of survival time estimated using the method of Kaplan-Meier.	5 Years

Collaborators and Investigators

• Sponsor: National Cancer Institute (NCI)
• Investigators: Principal Investigator: Jorge Romaguera, M.D. Anderson Cancer Center

Study record dates

Study Major Dates

• Study Start: September 1, 2006
• Primary Completion (Actual): April 1, 2011
• Study Completion (Actual): April 1, 2011

Study Registration Dates

• First Submitted: September 29, 2006
• First Submitted That Met QC Criteria: September 29, 2006
• First Posted (Estimate): October 3, 2006

Study Record Updates

• Last Update Posted (Estimate): May 20, 2014
• Last Update Submitted That Met QC Criteria: May 2, 2014
• Last Verified: April 1, 2013

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Immune System Diseases; Neoplasms by Histologic Type; Neoplasms; Lymphoproliferative Disorders; Lymphatic Diseases; Immunoproliferative Disorders; Disease Attributes; Lymphoma, B-Cell; Lymphoma; Lymphoma, Large B-Cell, Diffuse; Recurrence; Lymphoma, Non-Hodgkin; Lymphoma, Mantle-Cell; Antineoplastic Agents; Antibiotics, Antineoplastic; Romidepsin
• Other Study ID Numbers: NCI-2009-00240 (Registry Identifier: CTRP (Clinical Trial Reporting Program)); P30CA016672 (U.S. NIH Grant/Contract); N01CM62202 (U.S. NIH Grant/Contract); 2005-0579 (Other Identifier: M D Anderson Cancer Center); CDR0000486326; 7869 (Other Identifier: CTEP)